Introduction: Two thirds of countries globally are unprepared to respond to a health emergency as per the International Health Regulations ( 2005), with conflict-affected countries like Syria being particularly vulnerable. Political influences on outbreak preparedness, response and reporting may also adversely affect control of SARS-CoV-2 in Syria. Syria reported its first case on 22 March 2020; however, concerns were raised that this was delayed and that underreporting continues. Discussion: Syria's conflict has displaced more than half of its pre-war population, leaving 6.7 million people internally displaced. The consequent overcrowdingwith insufficient water, sanitation and healthcare (including laboratory capacity)could lead to conditions that are ideal for spread of SARS-CoV-2 in Syria. Political changes have led to the formation of at least three health systems within Syria's borders, each with its own governance, capacity and planning. This fragmentation, with little interaction between them, could lead to poor resource allocation and adversely affect control. As such, COVID-19 could overwhelm the health systems (particularly intensive care capacity), leading to high deaths across the population, particularly for the most vulnerable such as detainees. Conclusions: Locally implementable interventions that rapidly build WASH and health system capacity are required across Syria to ensure early detection and management of COVID-19 cases.

The Syrian conflict has led to a mass migration of Syrians to other countries and exposed them to many possible traumatic events and stressors in their country of origin and in the resettlement process. The possibility of positive psychological effects of adverse life events is less documented among Syrian refugees. Thus, the current study aimed to develop preliminary evidence for the identifying factors: traumatic experiences, post-migration stressors and coping strategies that are associated with post-traumatic growth (PTG) of Syrian refugees residing in Turkey. Structural equation modeling (SEM) was used in the current study to assess the associations among these factors. Data were obtained from Syrian refugees residing in the governorates of Hatay and Mardin. A total of 528 Syrians, aged between 18–77 years (M = 35.60, SD = 11.65) participated in this cross-sectional study. Results from the SEM indicated that past traumatic experiences and post-migration stressors were indirectly related to PTG. The results from the current study provide support for that the association between refugees’ traumatic experiences, post-migration stressors and PTG appear to be explained through the presence of coping strategies which could be addressed in the psychotherapies and psychosocial interventions for refugees to promote positive psychological change. Future studies should address the effects of post-migration stressors on PTG in detail.

Abstract. Providing a powerful platform to openly discuss how we, as a global community, can advance the role of women as leaders in health in conflict-affected settings is an undervalued opportunity. Honest, evidence-based discussions, holistic approaches, and increasing the visibility of women role models are imperative in settings that are debilitated by conflict and restrictive gender norms. When gender equity and equality are not prioritized, we tend to consciously or not overlook the needs of half the population. In the face of a global pandemic, it is ever more pressing to ensure that such discussions continue and are not relegated. The evidence is overwhelming, COVID-19 impacts women disproportionately, and this is exacerbated in conflict settings. The reflections in this commentary are based on a webinar held on October 21, 2020, supported by the Women Leaders in Health and Conflict initiative ( Abbara et al., 2020 ). The panelists included Dr. Aula Abbara, Dr. Abdulkarim Ekzayez, and Dr. Ola Fahham, and the webinar was attended by 30 participants from across the Middle East and the United Kingdom. We examine three key themes: women's role in the health sector in Syria, education and culture, and meaningful leadership.

IntroductionThe Syrian conflict that started in 2011 has been ongoing for over a decade without an end in sight. Estimates regarding excess mortality and conflict-related disability vary widely, and little field research has been done to address this topic.MethodsA population-based field survey was conducted from 10 to 18 November 2020 in Northwest Syria. Forty-nine clusters were selected using staged sampling based on predefined population distribution maps. Data were collected for the period from 2000 to 2020 and were divided into pre-conflict (2000–2010) and conflict (2011–2020) periods. Mortality rates were compared using the Mann-Whitney U test, and p<0.05 was considered statistically significant.ResultsA total of 1483 households were surveyed, for a population of 12 268 people. The crude mortality rate increased 3.55 times between the two periods (p>0.001). In total, 54.3% of war-related deaths were caused by aerial attacks. Despite the continued increase in mortality rates during the conflict period, most deaths from 2017 onwards were related to non-violent causes. Overall, directly and indirectly, the conflict seems to have caused approximately 874 000 excess deaths. A total of 14.9% of households reported having at least one substantial violence-related disability since 2011.ConclusionThe conflict caused the tripling of mortality rates in Syria. The estimated excess mortality in our study is higher than previous estimates. From 2017 onwards, most conflict-related deaths were due to non-violent causes. There is a high prevalence of violence-related disabilities in the studied communities. Our data could prove useful for health policymakers.